Diagnostic thoracoscopy: Malignant pleural effusion

Abstract

Malignant neoplasms are the second leading cause of death in the USA (Hoyert et al. 2006). Almost all neoplasms can metastasize to the pleura during their history, either as the initial presentation of cancer or during disease progression (Valdes et al. 1996). Every year, up to 150,000 cases of malignant pleural effusion are reported in the USA (Valdes et al. 1996). The optimal work-up for an undiagnosed pleural effusion remains a real problem for physicians (Froudarakis 2008). In developed countries, where the incidence of tuberculosis is low, a patient presenting with an undiagnosed pleural effusion has a significant likelihood of malignancy. Indeed, more than 50 % of the cases of undiagnosed pleural effusion are due to carcinomas; the second most common diagnosis (10 %) is tuberculosis (Valdes et al. 1996).